title: Cost analysis and benefits of opt-out HIV testing at a tertiary care centre in northern India.
abstract: Currently, in India, the National AIDS Control Organization does not recommend HIV screening for all patients attending health care facilities. The objective of study was to evaluate cost and benefits of opt-out HIV testing at a tertiary care hospital from India. This is a retrospective cohort study of patients who had undergone HIV testing. The cost for HIV testing and cost per HIV-infected patient were determined. A total of 6512 patients (66.4% men and 905 patients younger than 14 years) with mean (SD) age of 30.3 (20.7) years were tested for HIV infection during the study period. Overall, 137 (2.1%) patients tested positive for HIV infection. Total cost for performing HIV tests during study period was Indian Rupees (INR) 649,319 (US dollar [USD] 11805.8). The estimated cost per person tested was INR 99.71 (USD1.8) and cost per HIV-infected patient identified and referred to the antiretroviral therapy centre was INR 4739.55 (USD86.2). We determined a 2.1% period prevalence estimate for HIV infection. Based on cost per HIV-infected patient identified and referred to the antiretroviral therapy centre and the burden of HIV infection, it may be cost effective to perform routine opt-out screening for HIV infection in all patients attending health care facilities in developing countries like India.
authors.affiliation: Department of Immunopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Ranjana W
authors.initials: RW
authors.lastname: Minz
authors.forename: Anju
authors.initials: A
authors.lastname: Khairwa
authors.forename: Ritu
authors.initials: R
authors.lastname: Aggarwal
authors.forename: Harwinder
authors.initials: H
authors.lastname: Kaur
authors.forename: Surjit
authors.initials: S
authors.lastname: Singh
authors.forename: Aman
authors.initials: A
authors.lastname: Sharma
authors.forename: Subhash
authors.initials: S
authors.lastname: Varma
authors.forename: S N
authors.initials: SN
authors.lastname: Mathuria
authors.forename: Neelam
authors.initials: N
authors.lastname: Pasricha
mesh_terms: D000293:Adolescent; D000328:Adult; D003362:Cost-Benefit Analysis / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000191:economics*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D012189:Retrospective Studies; D063128:Tertiary Health Care / Q000458:organization & administration; D055815:Young Adult
keywords: AIDS; HIV; India; cost analysis; diagnosis; hospital-based; opt-out screening